Knee Osteoarthritis Care Issues and Measures

Layered management of pain, adaptive functional exercises, and correction of daily behavior patterns eliminate the need to rely too much on folk remedies or worry about surgery in advance. Standardized care can allow more than 80% of early- and mid-stage patients to maintain normal life functions.

Don't tell me, I have been in the orthopedic clinic for so long, and the most common misunderstanding I encountered is that patients have extreme attitudes towards pain: either they are limping in pain and still carrying it, saying "you can't take painkillers because you are addicted", or you take painkillers to create joints when you are slightly sore, which is the first pitfall of care. In fact, there are indeed two different intervention ideas for pain management in the industry: Traditional conservatives advocate giving priority to physical methods such as hot compresses and medium-frequency physiotherapy for relief, and try to avoid drug stimulation. ； The evidence-based medicine school believes that if the pain has affected sleep and caused compensatory walking posture, it is better to use short-acting anti-inflammatory drugs for 3-5 days as early as possible, which can avoid bilateral joint wear caused by long-term bad posture. Now our clinical practice generally adopts a compromise: for mild to moderate soreness, topical non-steroidal anti-inflammatory ointments, such as Voltaren and Etofenamate gel, are preferred. The side effects are almost negligible. ； If the pain is so severe that the score exceeds 4 points (out of 10 points, pain so severe that you cannot walk normally is about 5 points), then you can take oral medicine as needed, and there is no risk of addiction at all. There was a 62-year-old aunt who had been in pain for two months and dared not take medicine. Her knees were swollen like a steamed bun, and she had to be accompanied by her family members even when buying groceries. Later, she took topical medicine and short-wave physical therapy for a week according to the plan, and she was able to go downstairs and walk on her own.

Pain relief alone is definitely not enough. Many patients think they are better when the pain is gone, and then go to square dancing or climbing stairs to exercise. They come back for follow-up consultations within two months. The problem lies in the fact that the degree of functional exercise is not accurate. There is also controversy in this field: some rehabilitation practitioners emphasize the need to "nurture" and bear as little weight as possible to avoid wear and tear. ； Some people advocate "moving" and strengthening muscles to reduce the load on joints. In fact, both statements are correct, but the adaptation stages are different: when the joints are red, swollen and hot in the acute stage, you really need to stand less and walk less. Just lie down and do straight leg raises to train the quadriceps. 3 groups of 15 times a day will not put any burden on the joints. ； When the pain subsides and enters a stable period, you should move moderately. Swimming, brisk walking on flat roads, and squatting against the wall are all good choices. On the contrary, lying still for a long time will cause muscle atrophy and joint instability and more frequent pain. There was a 70-year-old man who heard someone say that "climbing stairs can wear out the joints." He climbed 10 floors a day for exercise, and the degeneration was dragged from mild to moderate in half a year. Later, he changed it to walking on a flat road for 30 minutes and squatting for 10 minutes every day. During the three-month review, the pain score dropped by 4 points, and he no longer needed to hold the railing when going up and down stairs.

The small details in daily life are the most easily overlooked. Many people think that nursing is just physical therapy and exercise. In fact, changing your daily behavior habits is more effective than anything else. Take knee braces for example. Some people say that if you wear them for a long time, your muscles will atrophy and you cannot wear them. Some people say that you will easily get injured if you don’t wear them. In fact, it all depends on the situation: when you go out for a long walk, go up and down stairs, or when you have acute pain, wearing supportive knee braces can help distribute the force on your knees. ； If you usually take it off at home or when doing muscle exercises, it will not cause muscle disuse atrophy. And as everyone often says, "Keep your cold legs warm," that doesn't mean you should wear cotton pants in the dog days of summer. Low temperatures and exposure to wind will indeed aggravate joint pain. Keeping warm can relieve discomfort, but there is no need to cover your legs when it's sultry in the summer. On the contrary, eczema will be more troublesome. The tips I usually give to patients are very down-to-earth: don’t sit on a soft sofa that’s lower than your knees. When you stand up, hold on to the armrests and don’t stand up suddenly with your knees. ； Try to use the toilet when going to the toilet. When squatting, the force on your knees is 7 times your body weight. Even if you squat for a long time, you may have problems. ； For every 1 kilogram of weight lost, the stress on the knees can be reduced by 4 kilograms. Keeping your mouth shut is more effective than eating ten boxes of amino sugar.

To put it bluntly, knee osteoarthritis is essentially a degenerative disease, just like a car axle that has been worn for decades. The purpose of care is never to turn it back to brand new, but to make it function stably for more than ten years. There is really no need to follow online tutorials. Some people’s joints are lightly worn and can be fine even if they occasionally climb a mountain. Some people are severely worn and it hurts even if they walk an extra five thousand steps. Just find a rhythm that suits you. Don’t take it too seriously and put it off until you need surgery, and don’t be too anxious to even walk. It’s as simple as that.